title: [Influence of double workload in perceived health and health services utilization of immigrants and Murcian natives, Spain].
abstract: BACKGROUND
  Gender inequalities in health have been largely documented. The main objective of this study is to assess whether there are gender differences in perceived health and health services utilization, and their relation with double workload in a representative sample of immigrants and Murcian natives.
  
  
  METHODS
  We used data from the NHS 2006 and Health and Culture Study, 1,303 immigrants and 1,303 Spanish, both residents in the Region of Murcia. With the combination of reproductive work and paid work we built up the variable 'double workload' (DW). We estimated the prevalence ratio (PR) for positive self-perceived health, chronic morbidity, activity limitation, doctor's visits, hospitalization, emergency and drug use, by origin, using regression methods. Two models were constructed by adding double burden to the basic model adjusted by sociodemographic variables. Analyses were performed between and within sex.
  
  
  RESULTS
  After adjusting for DW, no changes were seen in the differences by gender [RP women/men of positive perception health: 0.70 (0.54-0.89) East European; 0.87 (0.79-0.95) autochthonous / chronic morbidity: 1.44 (1.14-1.82) Hispanic; 1.36 (1.19-1.55) autochthonous / activity limitation: 2.23 (1.29-3.83) Hispanic; 1.45 (1.01-2.10) autochthonous / doctor's visits: 1.93 (1.50-2.48) Hispanic; 1.74 (1.06-2.86) Moroccan; 1.32 (1.09-1.59) autochthonous / hospitalization: 1.80 (1.02-3.17) Hispanic], almost the same than unadjusted. Women used more drugs than men. Within sexes, both autochthonous men (1.19; 1.06-1.33) and women (1.18; 1.01-1.40) with shared DW had more positive self-perceived health than those without DW. Hispanic men with DW without assistance: 0.67 (0.47-0.94).
  
  
  CONCLUSIONS
  Women have worse health indicators and greater use of health services regardless of origin. Consideration of the double workload does not explain gender inequalities in health.
authors.affiliation: Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, España.
authors.forename: Ana Belén
authors.initials: AB
authors.lastname: Moreno López
authors.forename: Mónica
authors.initials: M
authors.lastname: Ballesta Ruiz
authors.forename: Diego
authors.initials: D
authors.lastname: Salmerón Martínez
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro Sánchez
authors.forename: María José
authors.initials: MJ
authors.lastname: Tormo Díaz
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D054242:Emigrants and Immigrants; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D016526:Workload; D055815:Young Adult